On February 8, more than fifty participants (researchers, physicians, students, and community organization representatives) gathered for a “Science Café” to discuss data from the Engage study of gay and bisexual men and men who have sex with men (or ” gbMSM”). This study started in 2017 and ended in 2023, thus covering the period of the Covid-19 pandemic and its restrictions. The Engage study included the cities of Montreal, Toronto and Vancouver with the largest number of participants in…Montreal! Everything took place at the Maison du développement long-lasting in the city center of the metropolis.
Engage was funded by the Canadian Institutes of Health Research (CIHR). Dr. Gilles Lambert from the Institut national de santé publique du Québec (INSPQ) and Joseph Cox from McGill University were the key leaders and researchers of this large Engage team.
As people happily ran across the street at L'espace quiete, numbers flashed on screens as researchers took turns publishing the results of the survey data.
“RÉZO has been Engage's community partner in Montreal for several years since its beginnings and is proud to have worked with the research team, leading many of its actions and, above all, helping to mobilize hundreds of people to take part in the study,” emphasizes Alexandre Dumont-Blais, the general director of the RÉZO organization.
A total of 2,449 gbMSM participated in this study in Montreal, Toronto and Vancouver, with more than 1,1000 people in Montreal, almost half of the cohort. Of the 2,008 people who were HIV negative or did not know their HIV status, 1,159 were candidates for PrEP (sexual pre-exposure prophylaxis) treatment recommendations, “and half felt they would need it at some point or later.” “Others during the last six months, but only twenty percent (20%) had actually used it,” we can read on the Canadian HIV Trials Network website.
“The data presented on February 8 at Café Scientifique confirms some of our observations on the ground by our intervention teams: the provision of an adapted service, that is, taking into account the realities, lives and practices of GBQ men.” [gais, bisexuels ou queer] and transsexuals who have relationships with men are essential, otherwise these people would use fewer health services, emphasizes Alexandre Dumont-Blais. Rapid access to screening, and in particular access to PrEP, a scientifically recognized tool for HIV prevention around the world, remains a critical issue: Can all people who should and/or want to take PrEP really do so? Do you have the budget? (between $55 and $65 per month if taken daily).”
“It’s clear that by promoting and providing access to PrEP, we can also achieve better outcomes in the gay/bisexual men’s community. Only about half of those who could benefit from it are still using it. Sometimes it is a question of cost and there is a solution that lies in free PrEP as a public health measure,” adds Ken Monteith, the director general of COCQ-Sida (Quebec Coalition of Community Organizations to Fight AIDS), which took action as moderator of this mini science congress.
Of these men, 32.6% were between 18 and 29 years old, 28.8% were between 30 and 39 years old, 14.1% were between 40 and 49 years old, 15.4% were between 50 and 59 years old, and 9.2% were 60 years and older.
“Organizing feedback activities to the community with research results is very important and we can be proud of our achievements in this regard,” says Ken Monteith. These activities increase people's confidence to participate in future studies, and we have seen this in the speed of recruitment for Engage in Montreal compared to other participating cities. […] A longitudinal study like Engage allows us to track the evolution of practices in our community and adapt our interventions to better meet current needs.”
According to the latest statistics, there were 62,790 people living with HIV/AIDS in Canada (for 2020). Of these, 33,335 are gbMSM or 53.1% of the total. “According to Canadian HIV estimates, 709 new HIV infections in Canada in 2020 were gbMSM (46.6% of all new infections). This estimate included 666 new HIV infections among men who had sex with men and 43 new HIV infections among men who injected drugs and had sex with other men,” the CATIE website says.
We learn in Engage that more than three quarters (3/4) of participants used dating sites and applications for sexual relationships with one or more partners.
For those who practice “chemsex” (sexual relationships involving drug use), also called P'N'P (Party'n'Play), the most commonly used drugs were cocaine (powder) or crack, crystal meth, GHB and ecstasy/ MDMA or even ketamine. At the start of the study, 5.1% of participants injected primarily crystalmeth. “GBMSM who inject are at higher risk of contracting the HIV virus and hepatitis C than others.” [qui ne s’injectent pas]emphasizes Dr. Joseph Cox. […] For those who are susceptible, crystal meth has some impact on condomless anal sex with regards to STBBI infections (sexually transmitted and blood-borne infections). […]» On the other hand, we also observed that a large proportion of participants sought help to reduce their consumption. Which in itself is good news.
“COVID-19 has had a significant impact on consumption: temporary reductions for certain substances due to the closure of bars and borders, while others such as cannabis were maintained, estimates Ken Monteith. […] Access to mental health care and services remains problematic, particularly for people who do not have regular contact with the healthcare system.”
“In addition, the conclusions of the study suggest that one of the keys to reducing STBBI/HIV transmission in particular is to offer different service points that are accessible differently than in the usual places, such as what RÉZO opened in the summer. ” 2023, the Pink Zone: a screening/intervention space in the heart of the Village, rue Sainte-Catherine, in a climate-controlled container, with a giant pink cone on the roof: attention-grabbing to raise awareness of screening and health of our communities , comments Alexandre Dumont Blais. “Proximity initiatives work and must be supported, and collaboration with public health, clinical and community authorities must continue to address STBBI transmissions.”
“Gay and bisexual men face numerous issues related to their identity – homophobia in their communities of origin and racism in the gay community. This increases the challenges faced by all members of the community and complicates responses. “It’s definitely important for the community to develop better answers,” concludes Ken Monteith.
INFO: www.engage-men.ca